Optimal time of administration of fentanyl in reducing hemodynamic response in endotracheal intubation | Taqwin | Journal of the Medical Sciences (Berkala ilmu Kedokteran) 5043 8628 1 SM

J Med Sci
Sci, Volume 46, No. 2, June: 78 - 87
Volume 46, No. 2, June 2014: 78-87

Optimal time of administration of fentanyl
in reducing hemodynamic response in
endotracheal intubation
Guntur Muhammad Taqwin1 *, I Gusti Ngurah Artika2 , Sri Rahardjo 2
1
Dr Soeselo District Hospital Slawi, Center Java, 2 Department of Anesthesiology and
Reanimation, Faculty of Medicine/Dr Sardjito General Hospital, Universitas Gadjah Mada,
Yogyakarta

ABSTRACT
Laryngoscopy and endotracheal intubations are frequently conducted in general anesthesia.
However, it can stimulate symphatic and sympatoadrenal activities. Several non and
pharmacological interventions have been used to reduce the symphatic stimulation. Fentanyl is
one of the opioid drugs that frequently used to decrease the cardiovascular responses after the
intubations. In order to obtain an optimal effect, fentanyl should be administered in appropriate
time. This study was conducted to compare the time of fentanyl administration at 2, 5 and 7
minutes before endotracheal intubation to reduce hemodynamic responses. This was an

obervational study with a prospective cohort design on patients who were going to undergo
elective sugical using general anesthesia followed laryngoscopy intubation in Dr Sardjito General
Hospital and met the inclusion and exclusion criteria. The patients were then divided into 3
groups i.e patients who received fentanyl 1.5 µg/kg body weight (BW) intravenously (IV) 2
minutes (Group A), 5 minutes (Group B) and 7 minutes (Group C) before laryngoscopy intubations.
The hemodynmic responses including sistolic and diastolic blood pressure (SBP and DBP), mean
arterial pressure (MAP), heart rate (HR) and rate pressure product (RPP) were monitored and
recorded every 1 minute during 7 minutes period. The result showed that fentanyl administration
5 minutes before laryngeal intubation was more effective in the decrease hemodynamic response
that those 2 and 7 minutes. Significantly different in SBP in 2, 3, 4 and 7 minutes observations
was observed (p0.05).
The hemodynamic response after fentanyl
administration 2, 5 and 7 minutes before
laryngeal intubation including SBP, MAP, HR
and RPP are presented in FIGURE 1, 2, 3 and
4, respectively. The results showed that the
fentanyl administration 5 minutes before
laryngeal intubation (Group B) was more
effective in the decrease hemodynamic response
that those 2 (Group A) and 7 minutes (Group

C) before laryngeal intubation. Significantly
different in SBP in 2, 3, 4 and 7 minutes
observations was observed (p 12,000 have risk of miocard ischemia.
CONCLUSION
In conclusion, the administration of fentanyl
1.5 µg/kg BW IV at 5 minutes before
endotracheal intubation is more effective against
hemodynamic responses compare to those at 2
and 7 minutes before intubation.
ACKNOWLEDGEMENTS
We would like to thank Head of Department
of Anesthesiology and Reanimation, Faculty of
Medicine/Dr Sardjito General Hospital,
86

Universitas Gadjah Mada, Yogyakarta for their
support in this study. We would also like to thank
all patients who have participated in this study.
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